Information on ADHD Assessment and Treatment

1. Booking and records. Once a date is agreed we send a booking form. This asks for your consent to access your GP summary record, and invites you to upload anything relevant — previous assessments, treatment history or medical records. The more we have, the more thorough the assessment can be.

2. Questionnaires. You will receive psychometric and clinical questionnaires by email. Completing these beforehand means the appointment itself can be spent on the areas that need detailed discussion rather than on basic information gathering.

3. Informant information. We need contact details for someone who has known you well, ideally from childhood into adult life — a parent, sibling, long-term partner or close friend. They receive a form covering your early life and development, which takes around 30 minutes. If they cannot complete it online, a member of our team can gather the same information by telephone.

4. The appointment. A 90-minute appointment with your psychiatrist, covering a structured ADHD interview across your lifespan, followed by a discussion of the conclusions. This appointment involves only you; the informant does not attend.

5. Anything further, if needed. Where the picture is complex, we may ask for additional questionnaires or arrange a second appointment. This is part of getting the diagnosis right and carries no extra charge.

You can choose an online or in-person appointment when you book. Both follow the same protocol and carry the same diagnostic weight.

An ADHD assessment does not always end in an ADHD diagnosis. Other explanations may account better for the symptoms, and many mental health difficulties present in similar ways.

Our conclusion follows established diagnostic standards and our clinicians' professional judgement. It cannot be altered to fit an expectation or a pre-existing belief about the diagnosis, however strongly that belief is held, and whether it comes from your own reading, from family or from another professional.

You are always free to seek a second opinion elsewhere.

1. Meeting with parents or guardians — 90 minutes. Developmental history from early childhood to the present, mental health background including any previous concerns, diagnoses or treatment, physical health, and a detailed account of the ADHD concerns, when they began and how they affect daily life now.
2. Appointment with the child or young person. An age-appropriate mental health assessment together with a structured diagnostic interview for ADHD, conducted so that they feel comfortable and able to talk openly.
3. Information from school or college, to understand how difficulties show themselves in an educational setting.
4. Conners' rating scales, giving a standardised measure of symptoms across different environments.
5. Further psychiatric assessment where this is needed to complete the picture.
6. Feedback appointment with the family once all the information, including the questionnaire results, is available. We explain the findings, the diagnostic conclusion and, where ADHD is diagnosed, the treatment recommendations.

This approach takes account of the particular difficulty of recognising ADHD in childhood and adolescence, where development and environment both shape how symptoms appear.

A detailed support letter for the educational setting can be provided on request and is included in the assessment cost. It sets out the diagnosis, its likely effect on learning, and general recommendations for support.

Specific adjustments in the classroom are decided by the school with its own educational support team; our letter is intended to inform that discussion rather than to replace it.

Assessment fees cover the diagnostic evaluation only. Where the patient is 12 or over and decides to try medication, the treatment package is a further cost, and you will need a blood pressure monitor and weighing scales, which together cost around £40 to £50. For a child aged 7 to 11 the treatment fee is quoted on application, so the figures below apply from age 12.

Medication itself is paid directly to the pharmacy and typically costs £50 to £150 a month depending on the drug and the dose. Over a three-month titration that is roughly £150 to £450.

If your GP does not accept shared care, ongoing costs are monthly private prescriptions at £75 each (£900 a year), six-monthly ADHD reviews at £125 each (£250 a year), and continuing medication of £600 to £1,800 a year. That is around £1,750 to £2,950 a year while treatment remains entirely private.

If shared care is agreed, the cost falls to a single annual specialist review at £125, with your GP prescribing at NHS rates. This is much the cheapest long-term arrangement, but it depends entirely on your GP agreeing.

An ADHD diagnosis requires a specific, structured assessment and cannot be made within a standard psychiatric consultation.

The assessment must establish that current difficulties meet the criteria set out in ICD-11, that the symptoms arise from ADHD rather than another condition, and that they are not better explained by another mental health problem. That differential process is the heart of the assessment, because a great many conditions produce symptoms that resemble ADHD.

A standard psychiatric assessment does not include an ADHD evaluation, and the two are charged separately.

A diagnosis is unlikely to be reached where severe symptoms of certain other conditions are present: severe anxiety or depression, active suicidal thoughts, hypomania, or significant use of alcohol or recreational drugs.

These conditions overlap heavily with ADHD, affecting emotion, impulsivity, concentration, organisation and executive function. While they are active it becomes very difficult to separate lifelong ADHD symptoms from their acute effects, and the diagnostic process requires that separation to be made with confidence.

Where this applies, we recommend addressing the acute difficulty first. Once it has been treated and functioning has returned to a stable baseline, an ADHD assessment can be requested. This gives the most accurate outcome.

We cannot ask NHS services to provide treatment following a private diagnosis, and we cannot direct a GP to prescribe ADHD medication, which requires specialist initiation. Only once a stable dose has been established under specialist care can a GP potentially take over prescribing.

Our assessments follow established NICE guidance and recognised diagnostic standards. Even so, we cannot guarantee that any particular organisation will accept the diagnosis. Universities generally accept private ADHD diagnoses for disability support, though they may ask for specific documentation. Employers vary; some accept a private diagnosis, others require an occupational health assessment. Educational institutions usually accept them for support purposes. The NHS does not normally accept a private diagnosis for treatment purposes unless the assessment formed part of an NHS-commissioned service, although your GP will always be informed.

We also cannot prescribe on the basis of another clinician's assessment. This is standard psychiatric practice: the prescribing clinician carries direct clinical responsibility and must have made their own evaluation.

Two conversations are worth having before you book.

Tell your GP that you are pursuing a private ADHD assessment, which keeps communication with your practice straightforward.

Then ask whether, if you are diagnosed, they would be willing in principle to enter a shared care arrangement once the initial titration period is complete. Knowing your GP's position before you begin makes it much easier to plan, because it determines what ongoing treatment will cost.

There are currently significant shortages of some ADHD medications.

This can limit which treatments are available, make some GPs more reluctant to enter shared care because supply is uncertain, and interrupt continuity once treatment has started. It is worth knowing before you begin.

All our prescriptions are processed through Signature Pharmacy, who operate a waiting list when a medication is temporarily out of stock and dispatch as soon as it arrives.

You will receive a full written report within four weeks, setting out the process, the findings and the recommendations. Occasionally annual leave or illness delays this, and we will tell you if that happens.

Once you have it, you are free to share it with anyone you choose — healthcare providers, schools, universities or employers.

Adult reports also include selected self-help material, chosen to help you understand ADHD and build practical skills for managing it, covering organisation, emotional regulation and relationships.

We can provide letters to third parties, and these are included in the assessment fee when requested at the time of assessment:

• Confirmation of diagnosis for an employer, without unnecessary clinical detail
• Documentation supporting an application for reasonable adjustments in education
• Travel letters for carrying controlled medication, meeting international requirements

A letter can also set out the general workplace adjustments that commonly help people with ADHD, such as flexible working, a quiet workspace or written instructions for tasks.

What a report cannot do is specify the exact adjustments for a particular job. That requires an individual occupational health assessment of your role and workplace, which is a separate service.

For students, an ADHD diagnosis can unlock substantial support. A confirmation letter can support an application for Disabled Students' Allowance, which may fund extra time in examinations, a separate room to reduce distraction, additional breaks during long exams or lectures, assistive technology, and mentoring focused on ADHD-specific study and organisation skills.

We provide the documentation needed for these applications.

ADHD medications act on the brain's dopamine and noradrenaline systems, which are involved in attention, impulse control and executive function.

Where they work, they can improve focus, reduce distractibility and make it easier to follow tasks through. They can reduce impulsivity, which shows in better decision-making, less interrupting and steadier emotional regulation. Hyperactivity often settles, and many people describe a sense of inner calm.

Around 70 per cent of people with ADHD notice a clear improvement. The benefits often extend beyond the core symptoms to organisation, time management and prioritising, and medication may also ease the anxiety and sense of overwhelm that frequently follow years of untreated ADHD.

Medication is not a general solution for mental health difficulties. It targets ADHD symptoms and does not treat conditions that may sit alongside ADHD, such as a primary anxiety disorder, depression or the effects of trauma.

Responses vary widely. Some people gain a great deal; others find little benefit, or side effects that outweigh it. Around 30 per cent do not respond adequately, and if medication proves ineffective after titration it would be stopped — which means the treatment package fee and medication costs may not lead to ongoing treatment. Trying a further medication after a first has failed carries a lower success rate and would fall outside the package.

In people with underlying anxiety or mood problems, stimulants can sometimes increase anxiety or irritability, or worsen mood.

The evidence is consistent that medication works best alongside other things rather than on its own: regular exercise, adequate sleep and structured routines, psychological work such as CBT adapted for ADHD, and adjustments at work or in education.

All ADHD medications carry potential risks.

There is a low but real risk of effects on heart rhythm, which is why a baseline ECG is sometimes required. More commonly there are mild increases in heart rate and blood pressure that need monitoring. Appetite suppression is common early on and weight may fall. Sleep can be affected, particularly if medication is taken later in the day. Some people notice mood changes or increased anxiety while starting.

Where there is a history of heart problems, extra caution applies. Medication may be contraindicated altogether, or offered only where the benefit clearly outweighs the risk, and that decision often needs input from other medical specialists.

Before any medication starts, baseline blood pressure, pulse and weight must be within satisfactory ranges.

The common medications. Methylphenidate comes in several formulations: immediate-release lasts three to four hours, modified-release eight to twelve. Lisdexamfetamine is a stimulant giving day-long control with once-daily dosing. Atomoxetine is a non-stimulant alternative for those who cannot take stimulants or do not respond to them, and typically takes several weeks to reach full effect.

You can read detailed information about these medications and their side effects at Choice and Medication.

Choosing. For most people a stimulant is appropriate first-line treatment. The choice also takes account of your own preferences about side effects and dosing convenience, your medical history, any co-occurring physical or mental health conditions, and current supply. The final decision is made at your first titration appointment, once blood test results are available.

Finding the dose. There is no standard effective dose. It cannot be predicted from age, sex, body weight or symptom severity, and responses differ even between family members who both have ADHD. Titration starts low and increases gradually while effectiveness and side effects are monitored, aiming for the best balance between the two. This usually takes about three months, and longer in roughly 20 per cent of cases where the medication or schedule has to change.

To titrate safely and judge what the medication is actually doing, certain things need to be in place.

Treatment should begin during a settled period, without major life changes or stressors that would confuse the picture, and with a reasonably structured daily routine. There should be no acute medical or mental health problem that would interfere or add risk.

Recreational drugs and non-prescribed medication must be avoided, as they can interact dangerously or mask the medication's effects. Alcohol should be minimal — a few units occasionally at a weekend rather than regular or heavy use.

Significant mental health difficulties take priority and need addressing first. That includes severe anxiety or depression, active suicidal thoughts and substance use disorders. Treating ADHD while these are active is often ineffective and can be harmful.

If more than six months pass between assessment and deciding to try medication, an additional psychiatric review is needed, because circumstances change.

Appointments. Six 15-minute remote appointments at week 0, then weeks 2, 4, 6, 8 and 12 — close together at first, further apart as treatment settles. They are held by secure video, and the days and times available depend on your psychiatrist's clinic schedule. The first covers medication options, their benefits and risks, and a joint decision about what to start.

Prescriptions. All private prescriptions needed during the three-month titration period. Medication costs themselves are separate and payable to the pharmacy.

Email support for urgent queries about medication effects or side effects throughout titration, with no administrative charge, which is when questions most often arise. Responses are usually within 72 hours, with urgent matters prioritised.

Shared care request, where your GP has confirmed in writing beforehand that they are willing in principle to take over prescribing. Without that confirmation we cannot process a shared care request afterwards, as GPs need advance notice to plan for it.

After your place is confirmed there is usually a four to six week wait before appointments begin, which allows for preparation, baseline measurements and any blood tests.

Titration takes three months for around 80 per cent of patients. In about 20 per cent it runs longer, usually because the first medication has to be changed for insufficient benefit or intolerable side effects, or because supply problems interrupt treatment.

The package covers three months. Beyond that, extra appointments are charged at our current follow-up rate on the fees page, and prescriptions outside the package period are £75 each.

Home monitoring is not optional. Blood pressure, pulse and weight readings must be provided at the start of every appointment — by the patient, or by a parent where the patient is a young person. Appointments cannot go ahead without them, because they guide dosing decisions and keep prescribing safe. A blood pressure monitor and weighing scales cost around £40 in total, and for a young person the monitor needs a correctly sized cuff. Medication can raise pulse and blood pressure and change weight, and regular readings catch that early.

Additional tests may be needed depending on history and baseline readings. A baseline ECG may be necessary where there are cardiac risk factors or abnormal physical readings. Blood tests may be needed for liver function, particularly with atomoxetine, or for kidney function. These are not included in the package and are arranged either through your GP or privately; we can suggest providers we work with, though their fees are paid directly to them.

Professional standards require that we inform your GP about any treatment we provide, so assessment findings, treatment plans and prescription details are copied to them.

Your explicit consent to this is mandatory. We cannot prescribe without it, even where you would prefer your GP not to be involved, because it is a fundamental part of safe prescribing.

• Written confirmation from your GP, obtained before treatment starts, that they are willing in principle to accept shared care. Without this, practices will not accept a request made after titration
• The full three-month titration completed, with a dose stable for at least one month and no changes planned
• Clear evidence that the medication is improving symptoms and quality of life
• Side effects manageable and not needing ongoing specialist input
• Blood pressure, pulse and weight stable and recently recorded
• A recent consultation, so your GP has current information about your status and plan
• Your understanding of your responsibilities, and agreement to keep attending annual reviews

A template letter for opening this conversation with your GP is included in your assessment report. Using it before starting treatment is what secures the pre-agreement.

• Attend annual specialist reviews with us — these are mandatory for shared care to continue
• Attend GP monitoring appointments every six months
• Tell both your GP and us about any significant change in health, side effects or concerns
• Request prescriptions in good time so there is no gap in treatment

We continue prescribing, with the costs that go with it: monthly prescriptions at £75 each and six-monthly ADHD reviews at £125. These continue for as long as you remain in treatment with us.

ADHD medications are controlled drugs and follow specific legal requirements. They cannot be issued electronically, must be written on special forms with security features, and are sent by secure post. We cannot post them to patients directly. All are processed through Signature Pharmacy, who handle and record them appropriately and arrange delivery.

Prescriptions are issued once a week, usually on a Thursday, though this may shift if your psychiatrist is not working that day. To be included in that week's batch, a request must reach us by 5pm on Tuesday.

Allow time: posting, then one to two days in the post, then the pharmacy's own processing. Request your prescription seven to ten days before you need it.

Prescriptions issued during a follow-up appointment are free of charge. Outside appointments, and after the treatment package has ended, a controlled drug prescription is £75 and a non-controlled drug prescription is £25.

During titration, email support about medication is included at no extra charge.

Outside the package, administrative work is charged at £60 per 10 minutes, with a minimum charge of 10 minutes. This covers letters to third parties, complex administrative requests and non-urgent clinical queries between appointments.

In adults, the process establishes that ADHD symptoms were present in childhood and remain present now, that they began in childhood (before age 12), that they have persisted throughout life, that no other mental health condition better explains them, and that they cause significant impairment in two or more areas of life.

This draws on several sources together: a detailed clinical interview, standardised assessment tools, an informant account of childhood, any available childhood records, and a full psychiatric assessment. In children and young people, school information and Conners' rating scales serve the same purpose.

A central part of the assessment is separating ADHD from conditions that begin in adult life and cause similar difficulty with attention, organisation and impulsivity.

Depression can cause poor concentration and restlessness; bipolar disorder can involve impulsivity and overactivity during manic phases; anxiety disorders commonly produce concentration difficulty and physical restlessness; dissociative conditions can cause inattention and forgetfulness. Autism overlaps substantially with ADHD. Personality difficulties, particularly emotionally unstable personality disorder, involve impulsivity and emotional dysregulation. Substance use can both mimic and mask ADHD. Ordinary variation in personality and cognitive ability is sometimes mistaken for ADHD.

During titration, daily dosing is essential. It is what allows effects and side effects to be judged accurately, doses to be adjusted sensibly and steady blood levels to be reached. Missed doses delay finding the right dose.

Once you are stable there is more flexibility. With stimulants, occasional weekend breaks are generally acceptable if you want them, and some people find they reduce tolerance or give respite from side effects. Atomoxetine needs consistent daily dosing to maintain therapeutic levels, so breaks are not recommended with it.

You must inform the DVLA if ADHD significantly affects your ability to drive, or if medication causes side effects that could affect driving safety.

In practice this is uncommon in people receiving proper treatment. Research indicates that appropriate ADHD treatment usually improves driving safety by improving attention and reducing impulsivity, and most people on stable treatment do not need to notify. If you are unsure, discuss it with your clinician.

Psychological therapy. We can put you in touch with therapists experienced in ADHD, offering weekly individual sessions on organisation and time management, emotional regulation, relationship difficulties and CBT adapted for ADHD. You are free to work with someone else if you prefer. Therapy is a separate service with its own fees, discussed with the therapist.

Occupational therapy. Practical help with modifying your environment to reduce the impact of ADHD, workplace organisation systems, daily living skills and sensory regulation. This is charged separately from assessment and medication treatment.